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Dakota Dental and Wellness Center, A Different Kind of Dentistry
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Forms / Privacy

Home Forms / Privacy

By reading through and filling out the forms below, you’ll save yourself time when you come in for your appointment to your Dakota Dental Clinic. If at any time you have questions or need assistance, please call our Dakota Dental Center directly at 952.431.5774.

  • Financial Policy Form
  • Patient Info & Health History Form
  • Privacy Policy Form
  • After Treatment Instructions Form
  • Consent for Use Form

Insurance:

Your Dakota Dental Center is happy to process your insurance forms. However, remember that the insurance relationship is between you and your insurer, and you may need to contact your insurance provider yourself to obtain maximum coverage. Ultimately, it is your responsibility to pay for your visit to Dakota Dental.

 

Fees and Payments:

We encourage you to discuss payment options with the Dakota Dental staff prior to your dentistry services. We are aware that dental work can be expensive and understand that full payment may not be made at the time of service. Dakota Dental center accepts Visa, Mastercard, American Express and offers financing through Care Credit. Call our Apple Valley dental clinic to figure out a payment plan that works best for you.

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At Dakota Dental we want each patient to know they are part of our family. Our goal is that every person leaves with a smile that is not only healthy, but one which they can be proud of.

Dakota Dental Clinic P.A., complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Language Information
  • The Language Assistant Statement
  • The Top 15 Languages in Minnesota

Care Credit

Forms

  • Patient Info/Health History Form
  • Privacy Policy
Request an AppointmentReview Us!Pay Your Bill

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14682 Pennock Avenue Apple Valley, MN 55124
(952) 431-5774
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